Cargando…

Signal-averaged P wave analysis for delineation of interatrial conduction – Further validation of the method

BACKGROUND: The study was designed to investigate the effect of different measuring methodologies on the estimation of P wave duration. The recording length required to ensure reproducibility in unfiltered, signal-averaged P wave analysis was also investigated. An algorithm for automated classificat...

Descripción completa

Detalles Bibliográficos
Autores principales: Holmqvist, Fredrik, Platonov, Pyotr G, Havmöller, Rasmus, Carlson, Jonas
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2007
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2082277/
https://www.ncbi.nlm.nih.gov/pubmed/17925022
http://dx.doi.org/10.1186/1471-2261-7-29
_version_ 1782138170901528576
author Holmqvist, Fredrik
Platonov, Pyotr G
Havmöller, Rasmus
Carlson, Jonas
author_facet Holmqvist, Fredrik
Platonov, Pyotr G
Havmöller, Rasmus
Carlson, Jonas
author_sort Holmqvist, Fredrik
collection PubMed
description BACKGROUND: The study was designed to investigate the effect of different measuring methodologies on the estimation of P wave duration. The recording length required to ensure reproducibility in unfiltered, signal-averaged P wave analysis was also investigated. An algorithm for automated classification was designed and its reproducibility of manual P wave morphology classification investigated. METHODS: Twelve-lead ECG recordings (1 kHz sampling frequency, 0.625 μV resolution) from 131 healthy subjects were used. Orthogonal leads were derived using the inverse Dower transform. Magnification (100 times), baseline filtering (0.5 Hz high-pass and 50 Hz bandstop filters), signal averaging (10 seconds) and bandpass filtering (40–250 Hz) were used to investigate the effect of methodology on the estimated P wave duration. Unfiltered, signal averaged P wave analysis was performed to determine the required recording length (6 minutes to 10 s) and the reproducibility of the P wave morphology classification procedure. Manual classification was carried out by two experts on two separate occasions each. The performance of the automated classification algorithm was evaluated using the joint decision of the two experts (i.e., the consensus of the two experts). RESULTS: The estimate of the P wave duration increased in each step as a result of magnification, baseline filtering and averaging (100 ± 18 vs. 131 ± 12 ms; P < 0.0001). The estimate of the duration of the bandpass-filtered P wave was dependent on the noise cut-off value: 119 ± 15 ms (0.2 μV), 138 ± 13 ms (0.1 μV) and 143 ± 18 ms (0.05 μV). (P = 0.01 for all comparisons). The mean errors associated with the P wave morphology parameters were comparable in all segments analysed regardless of recording length (95% limits of agreement within 0 ± 20% (mean ± SD)). The results of the 6-min analyses were comparable to those obtained at the other recording lengths (6 min to 10 s). The intra-rater classification reproducibility was 96%, while the interrater reproducibility was 94%. The automated classification algorithm agreed with the manual classification in 90% of the cases. CONCLUSION: The methodology used has profound effects on the estimation of P wave duration, and the method used must therefore be validated before any inferences can be made about P wave duration. This has implications in the interpretation of multiple studies where P wave duration is assessed, and conclusions with respect to normal values are drawn. P wave morphology and duration assessed using unfiltered, signal-averaged P wave analysis have high reproducibility, which is unaffected by the length of the recording. In the present study, the performance of the proposed automated classification algorithm, providing total reproducibility, showed excellent agreement with manually defined P wave morphologies.
format Text
id pubmed-2082277
institution National Center for Biotechnology Information
language English
publishDate 2007
publisher BioMed Central
record_format MEDLINE/PubMed
spelling pubmed-20822772007-11-21 Signal-averaged P wave analysis for delineation of interatrial conduction – Further validation of the method Holmqvist, Fredrik Platonov, Pyotr G Havmöller, Rasmus Carlson, Jonas BMC Cardiovasc Disord Research Article BACKGROUND: The study was designed to investigate the effect of different measuring methodologies on the estimation of P wave duration. The recording length required to ensure reproducibility in unfiltered, signal-averaged P wave analysis was also investigated. An algorithm for automated classification was designed and its reproducibility of manual P wave morphology classification investigated. METHODS: Twelve-lead ECG recordings (1 kHz sampling frequency, 0.625 μV resolution) from 131 healthy subjects were used. Orthogonal leads were derived using the inverse Dower transform. Magnification (100 times), baseline filtering (0.5 Hz high-pass and 50 Hz bandstop filters), signal averaging (10 seconds) and bandpass filtering (40–250 Hz) were used to investigate the effect of methodology on the estimated P wave duration. Unfiltered, signal averaged P wave analysis was performed to determine the required recording length (6 minutes to 10 s) and the reproducibility of the P wave morphology classification procedure. Manual classification was carried out by two experts on two separate occasions each. The performance of the automated classification algorithm was evaluated using the joint decision of the two experts (i.e., the consensus of the two experts). RESULTS: The estimate of the P wave duration increased in each step as a result of magnification, baseline filtering and averaging (100 ± 18 vs. 131 ± 12 ms; P < 0.0001). The estimate of the duration of the bandpass-filtered P wave was dependent on the noise cut-off value: 119 ± 15 ms (0.2 μV), 138 ± 13 ms (0.1 μV) and 143 ± 18 ms (0.05 μV). (P = 0.01 for all comparisons). The mean errors associated with the P wave morphology parameters were comparable in all segments analysed regardless of recording length (95% limits of agreement within 0 ± 20% (mean ± SD)). The results of the 6-min analyses were comparable to those obtained at the other recording lengths (6 min to 10 s). The intra-rater classification reproducibility was 96%, while the interrater reproducibility was 94%. The automated classification algorithm agreed with the manual classification in 90% of the cases. CONCLUSION: The methodology used has profound effects on the estimation of P wave duration, and the method used must therefore be validated before any inferences can be made about P wave duration. This has implications in the interpretation of multiple studies where P wave duration is assessed, and conclusions with respect to normal values are drawn. P wave morphology and duration assessed using unfiltered, signal-averaged P wave analysis have high reproducibility, which is unaffected by the length of the recording. In the present study, the performance of the proposed automated classification algorithm, providing total reproducibility, showed excellent agreement with manually defined P wave morphologies. BioMed Central 2007-10-09 /pmc/articles/PMC2082277/ /pubmed/17925022 http://dx.doi.org/10.1186/1471-2261-7-29 Text en Copyright © 2007 Holmqvist et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( (http://creativecommons.org/licenses/by/2.0) ), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Holmqvist, Fredrik
Platonov, Pyotr G
Havmöller, Rasmus
Carlson, Jonas
Signal-averaged P wave analysis for delineation of interatrial conduction – Further validation of the method
title Signal-averaged P wave analysis for delineation of interatrial conduction – Further validation of the method
title_full Signal-averaged P wave analysis for delineation of interatrial conduction – Further validation of the method
title_fullStr Signal-averaged P wave analysis for delineation of interatrial conduction – Further validation of the method
title_full_unstemmed Signal-averaged P wave analysis for delineation of interatrial conduction – Further validation of the method
title_short Signal-averaged P wave analysis for delineation of interatrial conduction – Further validation of the method
title_sort signal-averaged p wave analysis for delineation of interatrial conduction – further validation of the method
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2082277/
https://www.ncbi.nlm.nih.gov/pubmed/17925022
http://dx.doi.org/10.1186/1471-2261-7-29
work_keys_str_mv AT holmqvistfredrik signalaveragedpwaveanalysisfordelineationofinteratrialconductionfurthervalidationofthemethod
AT platonovpyotrg signalaveragedpwaveanalysisfordelineationofinteratrialconductionfurthervalidationofthemethod
AT havmollerrasmus signalaveragedpwaveanalysisfordelineationofinteratrialconductionfurthervalidationofthemethod
AT carlsonjonas signalaveragedpwaveanalysisfordelineationofinteratrialconductionfurthervalidationofthemethod